Psychological Disorders

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Transcript of Psychological Disorders

What is Abnormality? Anxiety Disorders Mood Disorders Dissociative Disorders Antisocial Personality Disorder In ancient times, holes were cut in an ill person's head to let out evil spirits in a process called trepanningHippocrates believed that mental illness came from an imbalance in the body's four humors, or bodily fluids—first recorded attempt to explain abnormal behavior as due to some biological process During the Renaissance, the mentally ill were labeled as witches Anxiety disorders are all disorders in which the most dominant symptom is excessive (greater than it should be given the circumstances) and unrealistic anxiety Personality Disorders Psychological Disorders Abnormal behavior can be defined as behavior that is statistically rare Abnormality can be defined as deviant from social norms Can be defined as causing subjective discomfort, or emotional distress or pain Abnormality does not allow day-to-day functioning Causes a person to be dangerous to self or others A Working Definition of Abnormality... To get a clear picture of abnormality, it is often necessary to take all of these factors into account Criteria to consider:1. Is the behavior unusual?2. Does the behavior go against social norms?3. Does the behavior cause the person significant subjective discomfort?4. Is the behavior maladaptive or result in an inability to function?5. Does the behavior cause the person to be dangerous to self or others? Additionally, each of these criteria should be assessed according to the principle of cultural relativity, or the need to consider the norms and customs of another culture when diagnosing a person from that culture with a disorder Abnormal behavior that includes at least two of the five major criteria of abnormality is classified by the term psychological disorder, which is defined as any pattern of behavior that causes people significant distress, causes them to harm themselves or others, or harms their ability to function in daily life Models of Abnormality Theories of personality can be used to describe and explain the formation of disordered behavior and abnormal personality In biological models of abnormality, the assumption is that mental illnesses are caused by chemical or structural malfunctions in the nervous system Psychodynamic theorists assume that abnormal behavior stems from repressed conflicts and urges that are fighting to become conscious Behaviorists see abnormal behavior as learned Cognitive theorists see abnormal behavior as coming from irrational beliefs and illogical patterns of thought Biopsychosocial model: abnormal behavior is seen as the result of the combined and interacting forces of biological, psychological, social, and cultural influences Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) The DSM-IV-TR is a manual of psychological disorders and their symptoms The Pros and Cons of Labels: Labels help establish distinct diagnostic categories that professionals recognize and understand, and they help patients receive effective treatment Labels can also be dangerous—or at the very least, overly prejudicial Psychological labels can be long lasting and powerful, affecting not only how other people see mental patients, but how patients see themselves Phobic Disorders Panic Disorder Obsessive-Compulsive Disorder Acute Stress Disorder (ASD) Posttraumatic Stress Disorder (PTSD) Generalized Anxiety Disorder Causes of Anxiety Disorders Phobias: irrational, persistent fears 3 types of phobias... Social phobia: fear of interacting with others or being in social situations that might lead to a negative evaluation Specific phobia: an irrational fear of some object or specific situation, such a fear of being in small, enclosed spaces (claustrophobia) Agoraphobia: fear of being in a place or situation from which escape is difficult or impossible Panic attack: sudden onset of extreme panic with various physical symptoms: racing heart, rapid breathing, a sensation of being "out of one's body," dulled hearing and vision, sweating, and dry mouth, often with feelings that one is dying Panic disorder: disorder in which panic attacks occur frequently enough to cause the person difficulty in adjusting to daily life Panic disorder with agoraphobia: fear of leaving one's familiar surroundings because one might have a panic attack in public Obsessive-compulsive disorder consists of an obsessive, recurring thought that creates anxiety and a compulsive, ritualistic, repetitive behavior that reduces that anxiety Everyone experiences a little obsessive thinking from time to time or has some small ritual that just makes them feel better—the difference is whether or not a person likes to do the ritual (but doesn’t have to do it) or feels compelled to do the ritual and feels extreme anxiety if unable to complete it Distress caused by a failure or inability to successfully complete the compulsive behavior or mental act is a defining feature of OCD Acute Stress Disorder and Posttraumatic Stress Disorder are both related to exposure to significant and traumatic stressors Acute Stress Disorder (ASD): disorder resulting from exposure to a major stressor, with symptoms of anxiety, dissociation, recurring nightmares, sleep disturbances, problems in concentration, and moments in which people seem to "relive" the events in dreams and flashbacks for as long as 1 month following the event Posttraumatic Stress Disorder (PTSD): disorder resulting from exposure to a major stressor, with symptoms of anxiety, dissociation, nightmares, poor sleep, reliving the event, and concentration problems, lasting for more than 1 month Generalized anxiety disorder is a condition of intense and unrealistic anxiety that lasts 6 months or more Psychodynamic explanations point to repressed urges and desires that are trying to come into consciousness, creating anxiety that is controlled by the abnormal behaviorBehaviorists believe that disordered behavior is learned through both operant and classical conditioningCognitive psychologists believe that excessive anxiety comes from illogical, irrational thought processes Biological explanations of anxiety disorders include chemical imbalances in the nervous system, in particular lower levels of serotonin and GABA—may reduce the ability to calm reactions to stressGenetic transmission may also be responsible for anxiety disorders One way in which people with anxiety disorders may use irrational thinking is through magnification, or the tendency to interpret situations as far more dangerous, harmful, or important than they actually are Eating Disorders Schizophrenia Mood disorders, also called affective disorders, are disturbances in emotion Major Depression Bipolar Disorders Causes of Mood Disorders Has a sudden onset and is extreme sadness and despair, typically with no obvious external causeSymptoms include feeling depressed for most of every day, taking little or no pleasure in activities, feeling tired, having trouble sleeping or sleeping too much, experiencing changes in appetite and significant weight changes, experiencing excessive guilt or feelings or worthlessness, having trouble concentrating, and having thoughts of death or suicide, including suicide attemptsMost common of the mood disorders and is twice as common in women as in men Bipolar disorders are severe mood swings from major depressive episodes to manic episodes of extreme elation and energy with no obvious external cause Manic episodes may last from a few weeks to a few months Psychodynamic theories see depression as anger at authority figures from childhood turned inward on the selfLearning theories link depression to learned helplessnessCognitive theories see depression as the result of distorted, illogical thinkingBiological explanations of mood disorders look at the function of serotonin, norepinephrine, and dopamine systems in the brain; genes and heritability also play a part Anorexia Nervosa Bulimia Nervosa A condition in which eating is reduced to the point that a weight loss of 15 percent below expected body weight or more is the resultWhat causes anorexia is not yet fully understood—some theories involve biological explanations, while others point to psychological factors such as sexual abuse, perfectionism with a desire to control as many aspects of one’s life as possible, and family dysfunction A condition in which a person develops a cycle of "binging" (overeating enormous amounts of food in one sitting) and uses unhealthy methods to avoid weight gainMost individuals with bulimia engage in "purging" behaviors, such as deliberately vomiting after the binge or misuse of laxatives, but some may not, using other inappropriate methods to avoid weight gain such as fasting the day or two after the binge or engaging in excessive exerciseBinging itself may be prompted by an anxious or depressed mood, social stressors, feelings about body weight or image, or intense hunger after attempts to diet—binge continues due to lack of self-control Genetics, low levels of serotonin, and insensitivity to leptin (a hormone that influences appetite) may play a part in both anorexia and bulimia Dissociative disorders involve a break in consciousness, memory, or a person's sense of identity Dissociative Amnesia Dissociative Fugue Dissociative Identity Disorder (DID) Causes of Dissociative Disorders Dissociative amnesia involves loss of memory for personal information The reported memory loss is usually associated with a stressful or emotionally traumatic experience, such as rape or childhood abuse, and cannot be easily explained by simple forgetfulness Can be a loss of memory for only one small segment of time, or it can involve a total loss of one's past personal memories Dissociative fugue involves traveling away from familiar surroundings with amnesia about the trip and possible amnesia for personal information The individual may become confused about identity, sometimes even taking on a whole new identity in the new place Such flights usually take place after an emotional trauma and are more common in times of disasters or war Occurs when a person seems to have two or more distinct personalities within one body There may be a "core" personality, who usually knows nothing about the other personalities and is the one who experiences "blackouts" or losses of memory and time Fugues are common in dissociative identity disorder, with the core personality experiencing unsettling moments of "awakening" in an unfamiliar place or with people who call the person by another name Psychodynamic explanations point to repression of memories, seeing dissociation as a defense mechanism against anxiety Loss of memory or disconnecting one's awareness from a stressful or traumatic event is seen as adaptive in that it reduces the emotional pain Cognitive and behavioral explanations see dissociative disorders as a kind of avoidance learning... The person may feel guilt, shame, or anxiety when thinking about disturbing experiences or thoughts and start to avoid thinking about them This "thought avoidance" is negatively reinforced by the reduction of anxiety and unpleasant feelings and eventually will become a habit of "not thinking about" these things Biological explanations point to lower than normal activity levels in the areas of the brain responsible for body awareness in people with dissociative disorders Schizophrenia is a long-lasting psychotic disorder (involving a severe break with reality), in which there is an inability to distinguish what is real from fantasy, as well as disturbances in thinking, emotions, behavior, and perception Symptoms Categories Causes Delusions: false beliefs about the world (e.g., delusions of persecution, delusions of grandeur)Hallucinations: false sensory perceptions, such as hearing voices that do not really existDisturbed or disorganized thoughts: often lacking structure or relevance, most often displayed through disorganized speechChanges in mood: including flat affect (displaying little or no emotion)Disorganized or odd behavior: ranging from periods of immobility to odd gesturing or facial grimaces Disorganized: behavior is bizarre and childish, and thinking, speech, and motor actions are very disordered Catatonic: person experiences periods of statue-like immobility mixed with occasional bursts of energetic, frantic movement, talking Paranoid: person suffers from delusions of persecution, grandeur, and jealousy, together with hallucinations Positive symptoms are excesses of behavior associated with increased dopamine activity, whereas negative symptoms are deficits in behavior associated with decreased dopamine activity Biological explanations focus on dopamine, structural defects in the brain, and genetic influences in schizophrenia Rates of risk of developing schizophrenia increase drastically as genetic relatedness increases with the highest risk faced by an identical twin whose twin sibling has schizophrenia Stress-vulnerability model: suggests people with genetic markers for schizophrenia will not develop the disorder unless they are exposed to environmental or emotional stress at critical times in development Personality disorders are extremely rigid, maladaptive patterns of behavior that interfere with normal social interactions and relationships There are three basic categories of personality disorders: those in which a person is seen as odd or eccentric by others, those in which the behavior of the person is very dramatic or erratic, and those in which the main emotion is anxiety or fearfulness There are 10 recognized types of personality disorders Borderline Personality Disorder Causes The person has no morals or conscience and often behaves in an impulsive manner without regard for the consequences of that behaviorA rare form of antisocial PD is a serial killerNearly three to six times as many males are diagnosed with this disorder as females Borderline PD is characterized by a person who is clingy, moody, unstable in relationships, and suffers from problems with identityThe frequency of this disorder in women is nearly two to three times greater than in men Cognitive-learning theorists see personality disorders as a set of learned behavior that has become maladaptive—bad habits learned early on in life Belief systems of the personality disordered person are seen as illogical Biological relatives of people with personality disorders are more likely to develop similar disorders, supporting a genetic basis for such disorders Biological explanations look at the lower than normal stress hormones in antisocial personality disordered persons as responsible for their low responsiveness to threatening stimuli Other possible causes of personality disorders may include disturbances in family communications and relationships, childhood abuse, neglect, overly strict parenting, overprotective parenting, and parental rejection Future Directions in Psychopathology The DSM is constantly being revised DSM-5 is currently in development and will likely include a variety of updates associated with current research and changes in perspectives over the years Some changes involve the terminology used to describe disorders and their symptoms There is a push for greater social relevance and attention to cultural differences